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Seva Sadan R. K. Talreja College of Arts, Science and Commerce (164)

Application No :
University of Mumbai
M.G.Road, Fort, Mumbai-400032, Maharashtra(India)
2169443
Academic Year: 2023-2024 Regular
APPLICATION FORM

Course Applied for : B.Sc. Computer Science(with Credits) - Regular - PRN:2021016402050512

Rev16 - T.Y. B.Sc. CS Sem V [1S00155]  (-)

Application Date : 08/07/2023 Payment Category : 13

1.Personal Information
Candidate's Name(Regional) :
Candidate's Name as printed MOHAMMAD FAIZAN KHAN NIZAMODDIN KHAN
on Mark sheet : [*This name will appear on all University records/documents]
NIZAMODDIN Mother's
Father's/Husband's Name : SAKEENA KHAN
KHAN Name :
Mother
Marital Status : UnMarried
Tongue :
Place Of Birth : Beed Gender : Male Date of Birth (DD/MM/YYYY) : 09/03/2004
Blood Group : Religion : Country of Citizenship : India
Is Student NRI/ Foreign National : No Domicile State: Maharashtra
Address For Correspondence :
Location Area : Not
State : Maharashtra District : Thane Tehsil : Ulhasnagar City/Town/Village :
Available
Address (House
no,street/area/suburb C Block Behind R J School Pin Code : 421001
etc.) :
Contact details
Mobile
919130185801 Email ID: [email protected]
Number
2.Legal Reservation Information
Category Type :
Category : GEN
Open
Is Guardian from EBC (Economic
Is Specially Abled? No
Backward Class)?  No
3.Social Information(Additional Inforamtion)
Not Applicable
Paper Selected for:
Sem V [1S00155]
82904 - Information and Network Security 82906 - Web Services
82901 - Artificial Intelligence 82903 - Software Testing and Quality Assurance
82907 - Game Programming USCSP501 - Practical of Elective - I
USCSP502 - Practical of Elective - II USCSP503 - Project Implementation
USCSP504 - Practical of Skill Enhancement : USCS507
Sem VI [1S00156]

87002 - Cloud Computing 87003 - Cyber Forensics

87005 - Digital Image Processing 87006 - Data Science
87007 - Ethical Hacking USCSP601 - Practical of Elective - I
USCSP602 - Practical of Elective - II USCSP603 - Project Implementation
USCSP604 - Practical of Skill Enhancement : USCS607
Medium of Instruction : English
4.Guardian Information
Occupation of Guardian : Laborer Annual Income of Guardian : 0
5.Educational Details
Month and Exam
Name of Name of Board/University Name of Certificate Mark Out
Year of Seat CGPA %
Examination and State of University School/College No. Obtained of
Passing No.
MAHARASHTRA STATE
BOARD OF SECONDARY
Std 10th March 2019 -- -- 337.00 500.00 -- - -- 67.40
AND HIGHER SECONDARY
EDUCATION,
MAHARASHTRA STATE
Std 12th 12Th BOARD OF SECONDARY February
-- -- 517.00 600.00 -- - -- 86.17
(Science) AND HIGHER SECONDARY 2021
EDUCATION,
Your Last Qualifying Exam:
7.Other Information
Would you like to apply for Hostel accommodation required NA
DECLARATION
I hereby declare that all the information furnished by me in this application form is true, complete and correct to the best of my
knowledge and belief. I do understand that I need to obtain and produce all the required documents. I admit to having
understood what constitutes ragging and sexual harassment. I have read the guidelines related to the same. I hereby affirm that if
found guilty of ragging or sexual harassment I am liable for punishment according to the university regulations.

Place : Date  :
( Signature of the Candidate )
Document printed on Sat Jul 08 2023 20:38:59 GMT+0530 (India Standard Time)